Use of Champions Identified by Social Network Analysis to Reduce Health Care Worker Patient-Assist Injuries

Abstract

Safe patient handling and mobility (SPHM) programs recommend having champions, but have not indicated how to identify them and have confined their role to peer-based activities, limiting their ability to influence control measures. In a pilot program conducted at a community access hospital in Oregon, researchers applied social network analysis (SNA) of safety advice to identify champion candidates. Candidates were invited to complete mobility, communication, and quality improvement (QI) training modules to become champions. Champions' roles included peer-based instruction and participation in QI quarterly meetings with hospital leaders. The program process was evaluated through weekly e-mail check-ins and documentation of quarterly meetings. Outcomes were evaluated with a pre-post design, observing 12-month changes in self-reported leading indicators and Good Catch reports, as well as trends in patient-assist injuries (2011-2019). SNA identified six candidates, four of whom became champions. Champions completed 48 weekly logs. The quarterly meetings concerned unitwide SPHM training, equipment storage, and onboarding. Results showed significant improvements in equipment use, safety participation, and safety compliance, particularly among workers who would seek SPHM advice from champions or recently hired workers. Compared with the prior year, the Good Catch monthly entries increased from 11.69 to 28.81. The average annual incidence rate of patient-assist injuries dropped from 13.01 for the six years before the program to 3.7 per 100 full-time equivalents (FTE) for the two years after. A program with SNA-identified and QI-trained champions improved safety outcomes after one year. Better-designed evaluations are needed to establish the replicability and long-term impact of this program.